gas exchange (emily)
what does the upper resp. tract consist of
nose, mouth, sinuses, pharynx, epiglottis, larynx
what is the function of the upper resp. system
provides passage for air to be breathed in/out of lungs
where do we see gas exchange happen
in the lower resp. system
how many lobes are in the right lung
3
how many lobes in the left lung
2
what does the lower resp. tract consist of
trachea and bronchi
what lines the trachea
pseudostratified ciliated epithelium with c-shaped cartilage rings
the trachea branches into:
R&L primary bronchi, secondary bronchi, bronchioles, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveoli
what is the function of surfactant
prevents collapsing, lubricates, and reduces surface tension
what lines the alveoli
simple squamous epithelium and surfactant
what structure is the end point for inspired air and the site of gas exchange
alveoli
what is ischemia
insufficient blood flow of oxygenated blood to tissues
what is hypoxemia
reduced oxygen in arterial blood
what is known as the respiratory centre
medulla oblongata
what does the medulla oblongata control
RR, blood pH, change in O2 and CO2
what are the 3 dependents for oxygen delivery
temperature, pH, [of 2, 3-bisphosphoglycerate]
what is the function of 2,3-bisphosphoglycerate
supplies O2 to tissues, and located in erythrocytes
what are 2 forms that oxygen is transported in blood
binding to Hgb in RBC or dissolved in plasma
in pulmonary circulation, what kind of blood is gathered from the heart to be replaced with oxygen from the lungs
deoxygenated
where does inhaled oxygen move to from the alveoli
to blood and into capillaries
what is the pathway of carbon dioxide and water to get to the alveloi
from the blood in the capillaries to the air in the alevoli
what are 3 causes of impairment of gas exchange
ineffective ventilation, reduced capacity for gas transportation, and inadequate perfusion
what is the process of moving gases in and out of the lungs
ventilation
what process is dependent on the availability of hemoglobin
transport
what is the function of oxygen in transport
carried by hemoglobin from alveoli to cells for metabolism
what is the function of carbon dioxide in transport
produced by metabolism and is carried by hemoglobin from cells to alveoli to be eliminated
what is perfusion
blood transporting O2 containing Hb to cells, returning CO@ containing Hb to alveoli
what are factors that increase the metabolic rate
pregnancy, fever, infection
dehydration and decreased blood volume can cause:
hypovolemia
what is myocardial ischemia
insufficient flow from coronary artery to myocardium
what is impaired valvular function
acquired disorder of a cardiac valve caused by stenosis or regurgitation
what causes disturbances in conduction
electrical impulses that dont originate from the SA node
insufficient volume ejected into the system and pulmonary circulation, and left & right sided heart failure alter:
cardiac output
what is hyperventilation
exhaling more carbon dioxide
what is hypoventilation
slow breathing preventing sufficient amounts of O2 and CO2
what do etiologies that cause upper airway obstruction involve
inflammation, infection, or trauma of airway structures
comprimised airflow of which structures to the lungs can cause upper airway obstruction
nasopharnyx and oropharnyx
what are examples of anatomical obstruction
foreign body, tumor, or anatomical anomalies
what are examples of physiological obstructions
mucous plugs, swelling, bronchospasm
how would a patient present with an airway obstruction
acute distress, altered LOC, or signs of ability to move air
what is ventilation-perfusion mismatch
less oxygen entering alveoli and less carbon dioxide removed
what are the physiological effects of ventilation-perfusion mismatch
hypoxia, hypercapnia, and respiratory acidosis
if someone is wheezing, using accessory muscles, has cyanosis, and stridor, they may have:
an airway obstruction
what are the 2 intubations that can relieve an airway obstruction
nasotracheal and endotracheal
tracheostomy and cricothyroidotomy are ways to relieve:
airway obstruction
what is the pathway of clinical judgement
noticing, interpreting, responding, and reflecting
true or false all interactions require clinical judgement
false
in what cases would you notify a provider
emergency, admission, change in condition, and for clarification of orders or direction
what conditions increase the risk for respiratory failure
congenital heart defects and chronic pulmonary diseases
why is it important to be aware of enirvonmental conditions if a patient is recieving oxygen therapy at home
hazards, gas stove, kerosene space heaters, or present smokers
true or false oxygen is considered a medication
true
what administration routes of oxygen is delivered in high-flow
venturi mask and high-flow nasal cannula
what administration routes of oxygen is delivered in low-flow
low-flow nasal cannula, simple face mask, partial rebreather masks, and non-rebreather masks
what range of oxygen and flow rate does the standard nasal cannula deliver oxygen
24-44% at 6L/min
what oxygen delivery device delivers oxygen up to 60L/min
high-flow nasal cannula
what range of oxygen and flow rate does a simple face mask deliver oxygen
35-50% at 6-12L/min
what range of oxygen and flow rate does a non-rebreather mask deliver oxygen
60-90% at 10-15L/min